Unit 13 Infection Unit 13 Infection ControlControl

Pages 297-347Pages 297-347

Understanding ICUnderstanding IC

Microorganisms = microbes and must be seen Microorganisms = microbes and must be seen with a microscopewith a microscopeNonpathogens = ( normal flora ) which are Nonpathogens = ( normal flora ) which are microbes that are beneficial to us and certain microbes that are beneficial to us and certain body processesbody processesPathogens = microbes that can cause diseasePathogens = microbes that can cause diseaseRARE= Sometimes nonpathogens can become RARE= Sometimes nonpathogens can become pathogens when the bodies immune system is pathogens when the bodies immune system is compromised or if the nonpathogen enters an compromised or if the nonpathogen enters an area where the body is not used to itarea where the body is not used to it

Bacteria Bacteria ( Cocci )( Cocci )

Simple and one celledSimple and one celled

Multiply RapidlyMultiply Rapidly

Diplococci = (paired) Gonorrhea, Diplococci = (paired) Gonorrhea, Meningitis, and PneumoniaMeningitis, and Pneumonia

Streptococci = (chained) Strep ThroatStreptococci = (chained) Strep Throat

Staphylococci = (clustered) Staph Staphylococci = (clustered) Staph Infections, Boils, Wound Infections, Toxic Infections, Boils, Wound Infections, Toxic ShockShock

Bacteria Bacteria ( Bacilli )( Bacilli )

Rod Shaped w/wout FlagellaRod Shaped w/wout Flagella

In Spore Form hard to killIn Spore Form hard to kill

Tuberculosis, Tetanus, Pertussis Tuberculosis, Tetanus, Pertussis (Whooping Cough), Botulism, Diptheria, (Whooping Cough), Botulism, Diptheria, and Typhoid.and Typhoid.

Bacteria Bacteria (Spirilla)(Spirilla)

Comma Shaped = VibrioComma Shaped = Vibrio

Corkscrew Shaped = SpirocheteCorkscrew Shaped = Spirochete

Syphilis and CholeraSyphilis and Cholera

Common Treatment of BacteriaCommon Treatment of Bacteria

Antibiotics are used to kill BacteriaAntibiotics are used to kill Bacteria

Over a period of years and lack of new Over a period of years and lack of new Antibiotics, some forms of Bacteria have Antibiotics, some forms of Bacteria have become immune to the antibiotics we use become immune to the antibiotics we use todaytoday

ProtozoaProtozoa

One Celled animal like often found in One Celled animal like often found in decaying materials and contaminated decaying materials and contaminated waterwater

Some can cause Malaria, Amebic Some can cause Malaria, Amebic Dysentery, Trichomonas, and African Dysentery, Trichomonas, and African Sleeping SicknessSleeping Sickness

FungiFungiSimple plant like organisms that usually live on Simple plant like organisms that usually live on dead organic matterdead organic matter

Yeasts and Molds are two common forms that Yeasts and Molds are two common forms that can be pathogeniccan be pathogenic

Ringworm, Tinea Pedis, Histoplasmosis,Yeast Ringworm, Tinea Pedis, Histoplasmosis,Yeast Vaginitis, and ThrushVaginitis, and Thrush

* Antibiotics Do Not Kill Fungus* Antibiotics Do Not Kill Fungus

Antifungal Meds are very expensive and you Antifungal Meds are very expensive and you have to take them for a very long time and watch have to take them for a very long time and watch for liver damagefor liver damage

RickettsiaRickettsia

Parasite in nature and cannot live outside Parasite in nature and cannot live outside the hostthe host

Found in Fleas, Lice, Ticks, and MitesFound in Fleas, Lice, Ticks, and Mites

Typhus Fever and Rocky Mountain Typhus Fever and Rocky Mountain Spotted FeverSpotted Fever

Antibiotics are used for treatmentAntibiotics are used for treatment

VIRUSVIRUSSmallest and only visible w Electron Smallest and only visible w Electron MicroscopeMicroscopeCannot Reproduce unless in the host cellCannot Reproduce unless in the host cellSpread Human to Human by blood and Spread Human to Human by blood and body secretionsbody secretionsViruses are very hard to kill because they Viruses are very hard to kill because they are resistant to many disinfectants and not are resistant to many disinfectants and not affected by antibioticsaffected by antibioticsCommon Cold, Measles, Mumps, Chicken Common Cold, Measles, Mumps, Chicken Pox, Herpes, Warts, Influenza, and PolioPox, Herpes, Warts, Influenza, and Polio

VIRUSVIRUS HBV HBV

Hepatitis B ( Blood Borne ) HBV that Hepatitis B ( Blood Borne ) HBV that affects the liver and can lead to permanent affects the liver and can lead to permanent damage and scarringdamage and scarring

S/S Fever, Pain, Flu-Like Symptoms, ???S/S Fever, Pain, Flu-Like Symptoms, ???

Vaccine does exist and is mandatory in Vaccine does exist and is mandatory in Healthcare Facilities Healthcare Facilities

VIRUS HCVVIRUS HCVHepatitis C VirusHepatitis C Virus

Blood to Blood and Blood Containing Body Blood to Blood and Blood Containing Body FluidsFluids

Many are AsymptomaticMany are Asymptomatic

Most are Vague like HBVMost are Vague like HBV

Can cause very serious liver damageCan cause very serious liver damage

No current vaccineNo current vaccine

Both HCV and HBV can survive on Both HCV and HBV can survive on surfaces for several dayssurfaces for several days

AIDS and HIVAIDS and HIV

Suppresses the Immune SystemSuppresses the Immune System

Cannot fight infections or cancersCannot fight infections or cancers

Nonpathogens can become pathogenic in Nonpathogens can become pathogenic in naturenature

No CureNo Cure

Vaccine is currently being trialedVaccine is currently being trialed

EVERYONE is at Risk in the Healthcare EVERYONE is at Risk in the Healthcare EnvironmentEnvironment

MicroorganismsMicroorganisms

Aerobic ( Needs O2)Aerobic ( Needs O2)

Anaerobic ( Does Not Need 02)Anaerobic ( Does Not Need 02)

Some pathogens produce toxins that can Some pathogens produce toxins that can damage the nervous systemdamage the nervous system

Others can cause an allergic responseOthers can cause an allergic response

Others can seek and destroy living cellsOthers can seek and destroy living cells

Infection and Disease ClassInfection and Disease Class

Endogenous Endogenous Originates in the bodyOriginates in the body

Metabolic DisordersMetabolic Disorders

Congenital AbnormalitiesCongenital Abnormalities

TumorsTumors

Infections caused within the bodyInfections caused within the body

Exogenous Exogenous originates outside the bodyoriginates outside the body

Pathogens that attack the bodyPathogens that attack the body

RadiationRadiation

Chemical AgentsChemical Agents

TraumaTrauma

Electric ShockElectric Shock

Temperature ExtremesTemperature Extremes

Nosocomial Nosocomial Acquired in the Hospital or Healthcare Facility

Usually transmitted from the Healthcare Worker to the patients

Many are Antibiotic Resistant

Can be Life Threatening

OpportunisticOpportunistic Infections that occur when the body is weakened

Kaposi’s Sarcoma

Pneumocycstis Carinii Pneumonia

Conditions for Spreading Conditions for Spreading

Causative AgentCausative Agent

Reservoir ( can include Fomites )Reservoir ( can include Fomites )

Portal of ExitPortal of Exit

Mode of TransmissionMode of Transmission

Portal of EntryPortal of Entry

Susceptible HostSusceptible Host

1 Causative Agent1 Causative Agent

The pathogen, bacteria, fungus, or virus The pathogen, bacteria, fungus, or virus that can cause infectionthat can cause infection

2 Reservoir2 Reservoir

It must find a place to liveIt must find a place to live

Human BodyHuman Body

AnimalsAnimals

EnvironmentEnvironment

Fomites = objects contaminated with the Fomites = objects contaminated with the infection like doorknobs, bedpans, urinals, infection like doorknobs, bedpans, urinals, linens, instruments, etc..linens, instruments, etc..

3 Portal of Exit 3 Portal of Exit

The organism must have a way to escape The organism must have a way to escape to reservior it has been growing into reservior it has been growing in

In Humans pathogens leave through urine, In Humans pathogens leave through urine, feces, saliva, blood, tears, mucous feces, saliva, blood, tears, mucous discharge, sexual secretions, and draining discharge, sexual secretions, and draining woundswounds

4 Mode of Transmission4 Mode of Transmission

A way in which it can be transmitted to A way in which it can be transmitted to another reservoir or host where it can liveanother reservoir or host where it can live

Transmission:Transmission:– Person to PersonPerson to Person– Direct contact with SecretionsDirect contact with Secretions– Contaminated Hands (#1)Contaminated Hands (#1)– Indirect Contact = food, air, soil, insects, Indirect Contact = food, air, soil, insects,

feces, clothing, instruments, & equipmentfeces, clothing, instruments, & equipment

5 Portal of Entry5 Portal of EntryA way to enter the new host or reservoirA way to enter the new host or reservoir

Breaks in the SkinBreaks in the Skin

Breaks in the Mucous MembraneBreaks in the Mucous Membrane

Respiratory TractRespiratory Tract

Digestive TractDigestive Tract

Genitourinary TractGenitourinary Tract

Circulatory SystemCirculatory System

Normal Healthy Adults usually fight off Normal Healthy Adults usually fight off causative agentscausative agents

Body DefensesBody Defenses

Mucous Membranes = Lines the Mucous Membranes = Lines the Respiratory, Digestive, and Reproductive Respiratory, Digestive, and Reproductive Tracts and traps pathogensTracts and traps pathogensCilia = Tiny hairlike structures that line the Cilia = Tiny hairlike structures that line the respiratory tract and propel pathogens out respiratory tract and propel pathogens out of the bodyof the bodyCoughing and SneezingCoughing and SneezingHydrochloric Acid = Destroys pathogens in Hydrochloric Acid = Destroys pathogens in the stomachthe stomach

Body DefensesBody Defenses

Tears in the Eye = Contain Bacteriocidal Tears in the Eye = Contain Bacteriocidal Chemicals and flush the eyeChemicals and flush the eye

FeverFever

Inflammation = leukocytes, or WBC, respond Inflammation = leukocytes, or WBC, respond and destroy pathogensand destroy pathogens

Immune Response = Body produces antibodies Immune Response = Body produces antibodies (proteins that combat pathogens, and protective (proteins that combat pathogens, and protective chemicals secreted by cells, such as interferon chemicals secreted by cells, such as interferon and complement)and complement)

6 Susceptible Host6 Susceptible Host

If the body defenses are weak or the If the body defenses are weak or the pathogen too numerous, then the host is pathogen too numerous, then the host is susceptible to invasionsusceptible to invasion

When all of the Factors – 1-6 are in place, When all of the Factors – 1-6 are in place, it is known as the Chain of Infectionit is known as the Chain of Infection

If any of the links in the Chain of Infection If any of the links in the Chain of Infection are broken, then the transmission can be are broken, then the transmission can be preventedprevented

AsepsisAsepsis

Major way to break the Chain of InfectionMajor way to break the Chain of Infection

Defined as the absence of disease-Defined as the absence of disease-producing organisms or pathogensproducing organisms or pathogens

Any object or area that may contain a Any object or area that may contain a pathogen is considered contaminatedpathogen is considered contaminated

Asepsis is designed to eliminate and/or Asepsis is designed to eliminate and/or prevent contaminationprevent contamination

Common Aseptic TechniquesCommon Aseptic Techniques

HandwashingHandwashing

Good Personal HygieneGood Personal Hygiene

Use of Disposable GlovesUse of Disposable Gloves

Proper Cleaning of EquipmentProper Cleaning of Equipment

Proper Cleaning of InstrumentsProper Cleaning of Instruments

Thorough Cleaning of the EnvironmentThorough Cleaning of the Environment

Levels of AsepsisLevels of AsepsisAntisepsis Antisepsis =Prevents or Inhibits growth of =Prevents or Inhibits growth of pathogens but not spores and viruses. Can be pathogens but not spores and viruses. Can be used on the skin. Examples Alcohol, Betadine, used on the skin. Examples Alcohol, Betadine, and Listerineand Listerine

DisinfectionDisinfection =Destroys or kills pathogens, but =Destroys or kills pathogens, but not always effective against spores and viruses. not always effective against spores and viruses. Chemical and can be used on surfaces. Bleach Chemical and can be used on surfaces. Bleach and Zephirinand Zephirin

SterilizationSterilization =Destroys ALL microbes. Usually =Destroys ALL microbes. Usually steam under pressure, gas, radiation, and steam under pressure, gas, radiation, and chemicals. Instruments for surgery are usually chemicals. Instruments for surgery are usually autoclaved and chemically rinsedautoclaved and chemically rinsed

Handwashing ( 15-30 Seconds)Handwashing ( 15-30 Seconds)

When you arrive to workWhen you arrive to work

Before and After every Patient ContactBefore and After every Patient Contact

Anytime your hands become soiledAnytime your hands become soiled

Before and After Donning GlovesBefore and After Donning Gloves

Before and After Specimen CollectionBefore and After Specimen Collection

After Picking Up Trash, Using the Bathroom, After Picking Up Trash, Using the Bathroom, Coughing, SneezingCoughing, Sneezing

B/A Eating, Drinking, Smoking, Applying Lip B/A Eating, Drinking, Smoking, Applying Lip Balm, Inserting or Removing ContactsBalm, Inserting or Removing Contacts

Chain of InfectionChain of Infection

Draw your own Chain of Infection from Draw your own Chain of Infection from page 303page 303

Remember to make sure you have all the Remember to make sure you have all the definitions listed on page 298definitions listed on page 298

Remember to always WASH YOUR Remember to always WASH YOUR HANDS!!!!!!!!!!HANDS!!!!!!!!!!

Standard PrecautionsStandard Precautions

Rules developed by the CDC to prevent Rules developed by the CDC to prevent the transmission and contraction of the transmission and contraction of pathogens.pathogens.

Every body fluid must be considered a Every body fluid must be considered a potentially infectious material, and all potentially infectious material, and all patients must be considered potential patients must be considered potential sources of infection, regardless of their sources of infection, regardless of their disease or diagnosisdisease or diagnosis

Prevention of Communicable Prevention of Communicable DiseasesDiseases

Communicable Disease = is caused by a Communicable Disease = is caused by a pathogenic organism that can be easily pathogenic organism that can be easily transmitted to otherstransmitted to othersTransmission Based Isolation Precautions Transmission Based Isolation Precautions are methods to reduce the incidence of are methods to reduce the incidence of transmissiontransmissionStandard Precautions are ALWAYS Standard Precautions are ALWAYS observed, but in some instances, a patient observed, but in some instances, a patient is on a specific type of Isolationis on a specific type of Isolation

Airborne PrecautionsAirborne Precautions

For known or suspected to be infected with an For known or suspected to be infected with an airborne pathogenairborne pathogenExamples: Rubella (Measles),Examples: Rubella (Measles),Varicella (Chicken Pox), TB, and ShinglesVaricella (Chicken Pox), TB, and Shingles

• These patients are placed in a Negative These patients are placed in a Negative Pressure room with HEPA filter and the door Pressure room with HEPA filter and the door must remain closedmust remain closed

• Anyone entering must wear an N-95 or N-100 Anyone entering must wear an N-95 or N-100 MaskMask

• If the patient must be moved, they must wear a If the patient must be moved, they must wear a surgical mask during transportsurgical mask during transport

Droplet PrecautionsDroplet Precautions

Patient suspected or diagnosed with large Patient suspected or diagnosed with large particle pathogen that can be ejected from the particle pathogen that can be ejected from the nose or mouth within a 3 feet radiusnose or mouth within a 3 feet radiusExamples = Hemophilus Influenzae, Meningitis, Examples = Hemophilus Influenzae, Meningitis, Pneumonia, Sinusitis, Otitis Media, Diptheria, Pneumonia, Sinusitis, Otitis Media, Diptheria, Mycoplasma Pneumonia, Pertussis, Adenovirus, Mycoplasma Pneumonia, Pertussis, Adenovirus, Mumps, and Viral PneumoniaMumps, and Viral PneumoniaMask must be worn within 3 feet of the patient Mask must be worn within 3 feet of the patient The patient must wear a mask when being The patient must wear a mask when being transportedtransported

Contact PrecautionsContact Precautions

For patients with epidemiologically For patients with epidemiologically pathogen that is capable of being spread pathogen that is capable of being spread from patient to patient through direct or from patient to patient through direct or indirect contactindirect contactExamples = Any GI, RS, Skin, or Wound Examples = Any GI, RS, Skin, or Wound Infection caused by a Drug Resistant Infection caused by a Drug Resistant pathogens, Herpes, Diptheria, impetigo, pathogens, Herpes, Diptheria, impetigo, Pediculosis, Scabies, and StaphPediculosis, Scabies, and StaphGloves must be worn at ALL timesGloves must be worn at ALL times

Protective or Reverse IsolationProtective or Reverse Isolation

A method used to protect certain patients A method used to protect certain patients from organisms present in the from organisms present in the environment. environment.

Mainly used for Immunosuppressed Mainly used for Immunosuppressed PatientsPatients

Care PlansCare Plans

Plan of care for a patient and their Plan of care for a patient and their diagnosis considering their religion, family diagnosis considering their religion, family dynamic, and financial statusdynamic, and financial status